Influence of different image-acquisition protocols of cone beam computed tomography in the assessment of periodontal structures and on the alveolar bone height determination - in-vitro study

Abstract

Radiographic examination is helpful for the diagnosis, treatment plan and follow-up of periodontal diseases and intraoral radiographs have been the most used for this purpose. However, these radiographs do not provide a comprehensive vision of periodontal tissues, thus preventing a precise and detailed evaluation of alveolar bone and tooth-supporting structures. Due to limitations of intraoral radiographs, new imaging modalities like cone-beam computed tomography (CBCT) have been studied. The aim of this study is to evaluate the influence of different image acquisition protocols in CBCT, combining different scan degrees and exposure times, in the assessment of periodontal structures and on determination of alveolar bone height. The alveolar bone height on 252 sites of human dry skulls will be measured using a digital caliper (gold standard) and in CBCT images, this latter acquired with six different acquisition protocols. Three examiners, previously trained, will perform the radiographic measurements. Besides these measurements, they will subjectively rate the image quality of periodontal structures. The tomographic measurements will be compared to the gold standard by one-way analysis of variance. Intraclass correlation tests will be conducted for intra- and interobservers agreements. Wilcoxon signed-rank test will be conducted for the image quality evaluation. The significance level for all tests will be 5%. (AU)